Encyclopedia of

Iatrogenic illness

Literally meaning "physician-induced," the term
iatrogenic
describes diseases inadvertently resulting from medical treatments or
procedures. With more effective and powerful treatments have come side
effects that may be more common and harmful. There are efforts by medical
specialists and consumers to quantify and reduce iatrogenic side effects.
These efforts are hampered by the natural reluctance of physicians (and
other providers) to have their errors publicized and the prospect of
malpractice lawsuits. Physicians rarely report iatrogenic events, even
though most claim to have witnessed them. Efforts to make reporting
mandatory are resisted by the medical profession; therefore, lack of such
reporting makes it more difficult to identify and minimize hazards.

Despite these obstacles, the hazards of medicine are emerging in an
increasing number of studies and reports. A 2000 presidential report
described iatrogenic error and illness as "a national problem of
epidemic proportions," causing tens of thousands of annual deaths.
The report estimated the cost of lost income, disability, and health care
costs to be $29 billion a year. The report concluded that half of adverse
medical events were preventable.

The presidential report relied heavily upon another report by the
Institute of Medicine,
To Err is Human: Building a Safer Health System
(2000)
.
Issued by the most respected agency of American medicine,
To Err is Human
generated considerable attention and surprise by concluding that up to
98,000 Americans are killed annually by medical errors. This number
slightly exceeds the combined total of those killed in one year by motor
vehicle accidents (43,458), breast cancer (42,297), and AIDS (acquired
immunodeficiency syndrome, 16,516).

The Institute of Medicine utilized the findings of two large studies. One
found that 2.9 percent of people hospitalized in Colorado and Utah
experienced medical errors and 6.6 percent of those people died as a
result of the errors. The second study found that 3.7 percent of people
hospitalized in New York experienced errors and 13.6 percent of those
people died as result. This led the Institute to conclude that a minimum
of 44,000 Americans die annually due to error during hospitalization,
making it the eighth leading cause of death in the United States. Even so,
the report says that these numbers "offer only a very modest
estimate of the magnitude of the problem since hospital patients represent
only a small proportion of the total population at risk" (Institute
of Medicine 2000, p. 2).

While important, these reports fail to address major iatrogenic
controversies such as the under-treatment of people with chronic pain and
the repetitive misclassification of physical illnesses as psychiatric
disorders. (Diseases as wide-ranging as peptic ulcer, epilepsy, asthma,
and migraine have been so classified, leading to ineffective treatments,
suffering, and death.) However, another important source of iatrogenic
illness, the increase of drug-resistant infections due to overuse of
antibiotics, is otherwise being acknowledged and addressed.

The Centers for Disease Control and Prevention (CDC) estimate that each
year nearly 2 million
people acquire infections while hospitalized and about 90,000 die from
those infections. More than 70 percent of hospital-acquired bacterial
infections have become resistant to at least one of the drugs commonly
used to treat them.
Staphylococcus aureus
(staph), the leading cause of hospital-acquired infections, is resistant
to 95 percent of first-choice antibiotics, and about 30 percent of
second-choice antibiotics.

In New York City alone, treatment of people with hospital-acquired staph
infections exceeds $400 million, according to a study published in 1999.
Researchers found that staph infections doubled the length of
hospitalization, and more than doubled the patient death rate and per
patient costs.

The CDC proposes several methods of reducing hospital-acquired infections.
The most important include more discriminating antibiotic use and improved
hygiene of hospital staff, the main source of infections.

The modern state is, as Thomas Szasz has described it in
Pharmacracy: Medicine and Politics in America
(2001), a "therapeutic state" in which medical providers
have far more power than consumers. Such an imbalance of power may make
consumers increasingly vulnerable to the factors that cause iatrogenic
illness to be an important cause of illness and death.

User Contributions:

Question: I would like to find out if using more natural based medication would reduce the amount of side effects caused my medicines that are made from chemicals. Is it better to encourage natural and nutritional medication and discourage the more chemical type of medication that has these harmful effects in order to reduce the massive death rate?

Natural medicines are also 'made out of chemicals', the difference is that which chemicals they are made of, and how much, is less well known and understood and controlled, than for manufactured medicines. The amounts of each biologically active chemical in a natural source medicine, are variable and uncontrolled. It is much more difficult, for example, to maintain the therapeutic range of digitalis for your heart failure by using pieces of the foxglove plant, than by using a Digoxin pill with precisely calibrated active ingredient content. As a result, the 'natural' source of the same chemical is more likely to kill you from either under-treatment for a serious heart disorder, or from the toxicity of over-treatment, since the active digitalis alkaloid ingredients have such a narrow therapeutic range.

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